1. Field of the Invention
The present invention relates generally to optical electronic systems and methods. More particularly, the present invention relates to systems and methods for facilitating decision making about an individual based on mixed media information cards.
2. Related Arts
The use of information or identification cards has seen increasing use over the past several years as an effective means for quickly identifying an individual and a group or company with whom the individual is associated. Perhaps no industry has witnessed a more explosive growth in the use of these information cards than has the healthcare industry.
In the healthcare industry, healthcare sponsors, such as insurance companies, generally issue an information card, or healthcare plan identification card, to individuals in order to show that the individual is insured and to provide a variety of information about the individual and the individual""s insurance coverage. Conventionally, these cards have been presented to front office staff working, for example, in a doctor or dentist office when the individual arrives for an appointment. In conventional systems and methods, the front office staff manually enters the information contained on the card into a data gathering system, such as a patient log or computer database. Such information can include the name of the healthcare sponsor or the insurance company and personal information about the individual, including, but not limited to, the individual""s name, social security number or other individual numeric identifier, and the individual""s employer. This information is then used to generate bills or invoices or to provide additional information to the healthcare sponsor.
The conventional methods for entering and handling the information contained on the identification or business cards have presented numerous problems. These methods have generally not been capable of tracking and/or keeping up with changes of individual healthcare plans chosen by employers for their employees and the creation and marketing of new products by healthcare sponsors. In addition, the conventional methods have also resulted in incorrect information being entered into the computer system, which has led to incorrect billing of the healthcare sponsor, including billing the wrong address and incorrect collection of a co-pay amount from an individual at the time services are rendered. Another problem with conventional systems and methods has been that front office staff working in the office do not always follow the special utilization management requirements the healthcare sponsor may have, such as, obtaining precertification of certain outpatient procedures. Failure to follow these special procedures has resulted in loss of revenue to the doctor as well as administrative delays in providing insurance coverage. Yet another problem with conventional systems and methods has been front office staff cannot always determine if a particular physician participates in a plan. Such information is important in determining if the patient is within the plan""s network of approved physicians, outside the plan""s network of approved physicians, or not covered at all.
Various business card scanning systems have been developed for scanning business cards and storing the information printed on the business cards in an electronic database. The electronic database can then later be used to retrieve information about a particular individual or company. This retrieval process is similar to the conventional rolodex systems except that it can be performed electronically. Such scanning systems, however, are limited to extracting the data from the information cards and storing that data in the electronic database. Such conventional systems do not overcome the problems associated with healthcare sponsor identification cards.
Thus, there is a need to overcome the disadvantages described above. There is a particular need to provide a system and method that simply and reliably reads information contained on information cards to simplify the decision making process for front office staff and eliminate data input errors associated with conventional systems. There is a particular need for an automated system that reads information from insurance identification cards and identifies a healthcare sponsor and any special administrative procedures associated with the sponsor. There is a further need for storing information contained on the identification cards so that this information can be updated easily in cases of insurance coverage changes or other similar changes to group or healthcare sponsor offerings.
The present invention solves the problems with, and overcomes the disadvantages of, conventional information card management systems.
The present invention relates to a method for processing data contained on an information medium, the information medium being associated with an individual. The method includes extracting the data from the information medium and analyzing the data to determine a group identifier, wherein the group identifier identifies the individual as part of a group. The method further includes analyzing the data to determine a group product identifier and providing group product information based on the group product identifier.
In another aspect, the present invention relates to a system for processing data contained on an information medium associated with an individual. The system includes a scanner which is configured to extract data from the information medium. The system further includes a computer system in data communication with the scanner. The computer system includes a processor configured for analyzing the data to determine a group identifier, wherein the group identifier identifies the individual as part of a group, analyzing the data to determine a group product identifier, and providing group product information based on the group product identifier.
The present invention also relates to a computer program product including a computer useable medium having computer program logic recorded thereon for enabling a processor in a computer system to process data contained on an information medium. The computer program product includes first analyzing means for enabling the processor to analyze the data to determine a group identifier, wherein the group identifier identifies the individual as part of a group. The computer program also includes second analyzing means for enabling the processor to analyze the data to determine a group product identifier. The computer program further includes providing means for enabling the processor to provide group product information based on the group product identifier.
In another aspect, the present invention relates to a system for processing data contained on an information card associated with an individual. The system includes means for extracting the data from the information card and first means for analyzing the data to determine a group identifier, wherein the group identifier identifies the individual as part of a group. The system also includes second means for analyzing the data to determine a group product identifier and means for providing group product information based on the group product identifier.
The present invention also relates to a method for processing data contained on an identification card issued by a healthcare plan sponsor. The method includes extracting data from the identification card and analyzing the data to determine a healthcare plan identifier. The method also includes analyzing the data to determine a healthcare plan product identifier and providing healthcare plan product information based on the healthcare plan product identifier.
In another aspect, the present invention relates to a system for processing data contained on an identification card issued by a healthcare plan sponsor. The system includes a memory device having embodied therein executable code and a processor in communication with the memory device. The processor is configured for extracting data from the identification card and analyzing the data to determine a healthcare plan identifier. The processor is further configured for analyzing the data to determine a healthcare plan product identifier and providing healthcare plan product information based on the healthcare plan product identifier.
The present invention also relates to a computer program product including a computer useable medium having computer program logic recorded thereon for enabling a processor in a computer system to process data contained on an identification card issued by a healthcare plan sponsor. The computer program includes first analyzing means for enabling the processor to analyze the data to determine a healthcare plan identifier and second analyzing means for enabling the processor to analyze the data to determine a healthcare plan product identifier. The computer program also includes providing means for enabling the processor to provide healthcare plan product information based on the healthcare plan product identifier.
In yet another aspect, the present invention relates to a system for processing data contained on an identification card issued by a healthcare plan sponsor. The system includes means for extracting data from the identification card and a first means for analyzing the data to identify a healthcare plan identifier. The system also includes a second means for analyzing the data to identify a healthcare plan product identifier and means for providing healthcare plan product information based on the healthcare plan product identifier.
Features and Advantages
A feature of the present invention is that it provides for a reliable and efficient method and system capable of tracking and/or keeping up with changes to individual healthcare plans that are chosen by employers for their employees.
An additional feature of the present invention is that it provides for a simple system and method for accepting the creation and marketing of new products by healthcare sponsors.
Yet another feature of the present invention is that it provides for automated extracting and entry of data contained on information media and the subsequent analysis of that data based on previously stored information or information obtained directly from a healthcare sponsor.
An advantage of the present invention is that it substantially eliminates the manual entry techniques of conventional systems and the possibility of incorrect information being entered into the computer system, which has, in the past, led to incorrect billing of the healthcare sponsor.
Another advantage of the present invention is that it notifies front office staff of any special utilization management requirements the healthcare sponsor may have, such as, obtaining precertification of certain outpatient procedures. In this fashion, the present invention helps to simplify decisions for front office staff and helps to curb the loss of revenue to the doctor and the loss of time due to administrative delays inherent in conventional systems.